Anterior capsule coverage and rotational stability of an acrylic toric intraocular lens.

Purpose To investigate factors related to the rotational stability of an acrylic toric intraocular lens (IOL). Setting Four ophthalmic surgical sites in Japan. Design Prospective case series. Methods Subjects were 120 eyes of 120 patients undergoing phacoemulsification and implantation of a toric IOL (AcrySof IQ, Alcon Laboratories, Inc.). At 1 hour after surgery, the area of continuous curvilinear capsulorrhexis (CCC) was measured, and the state of anterior capsule coverage on the IOL optic (total on or partial on) was recorded. The toric IOL axis orientation was assessed at the end of surgery, 1 hour, 1 week, 1 month, and 6 months after surgery. Multiple regression analysis was performed to explore any clinical factors relevant to IOL rotation from the end of surgery to 6 months postoperatively. The explanatory variables included age, anterior chamber depth before surgery, axial length, type of corneal astigmatism (with-the-rule, against-the-rule, or oblique), area of CCC, state of anterior capsule overlap on IOL optic (total coverage vs. partial coverage), and surgical sites (surgeons). Results The multiple regression analysis indicated that anterior capsule overlap on the IOL optic was the only variable associated with IOL rotation at 6 months postoperatively (P = .0482). The mean absolute rotation at 6 months was 1.96 ± 1.81 degrees in the total on group and 3.79 ± 3.12 degrees in the partial on group (P = .0004). Conclusions Rotational stability of a single-piece, acrylic toric IOL was better in eyes with total anterior capsule coverage than partial anterior capsule coverage on the IOL optic.